Provider Demographics
NPI:1659865723
Name:JEWELL, MELISSA ANN (RD)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:JEWELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 S ORANGE AVE
Mailing Address - Street 2:SUITE 104 #1817
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801
Mailing Address - Country:US
Mailing Address - Phone:407-873-6568
Mailing Address - Fax:
Practice Address - Street 1:255 S ORANGE AVE
Practice Address - Street 2:SUITE 104 #1817
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801
Practice Address - Country:US
Practice Address - Phone:407-873-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2025-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
FLND7144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty